The Healing Lodge of
the Seven Nations (HL), a youth residential chemical dependency
treatment center, serves youth from seven tribal nations (from Idaho: Coeur
d'Alene Tribe, Kootenai Tribe and the Nez Perce Tribe; from Washington: The
Confederated Tribes of the Colville Reservation, Kalispel Tribe of Indians,
and the Spokane Tribe of Indians; and from Oregon, the Confederated Tribes
of the Umatilla Reservation) and beyond. Recognizing the lack of
programmatic research regarding best practices for supporting adolescents'
recovery within tribal nations, HL has developed a research partnership with
the Division on Addiction, Cambridge Health Alliance, a Harvard Medical
School Teaching Hospital (DOA). This partnership is the Center for
Indigenous Research, Collaboration, Learning, and Excellence (CIRCLE).
CIRCLE is excited to announce that it received an NIH/IHS Native American
Research Center for Health Award (NARCH). This CIRCLE-NARCH program, using a
Tribal Participatory Research (TPR) approach, will address gaps in knowledge
related to key components of sustainable recovery environments in tribal
nations by conducting a multi-site strengths and needs assessment study of
the seven nations' tribal recovery environment.

Risky behaviors, such as alcohol and drug consumption, gambling, and violent
or criminal activity, are a public health problem for youth across the
United States (Eaton et al., 2010). Native American youth, especially,
continue to be at elevated risk for some such harmful behaviors (Friese,
Grube, Seninger, Paschall, & Moore, 2011), and little is known about their
engagement in other behaviors (e.g., gambling). Consequently, it is
important to continue to examine risky behavior among Native American youth.
Likewise, it is equally important to pay as much attention to protective
factors against risky behavior. Working with Native American tribes to gain
information about risky behavior and protective factors will enable the
development of programs that address these issues and maximize wellness. To
gain information about areas of strength and those that require improvement,
the proposed project will partner with
The Healing Lodge of
the Seven Nations (HL), a residential youth chemical dependency center
that serves the Inland Tribal Consortium (ITC), to engage tribal youth in a
mutually-developed brief risk and resilience assessment during planned
community events. We have secured an agreement with HL and representatives
from the four ITC tribes (the Colville Confederated Tribes, Umitilla Tribe,
Kootenai Tribe, and the Kalispel Tribe) that will host youth community
events during 2014. The assessment includes central risk behaviors (e.g.,
gambling, alcohol use, violence) and resilience factors (e.g., Native
American enculturation and family connectedness) that have well-validated
reliable brief assessments available.

Grant from The Tung Wah Group of Hospitals

"Clinical Research & Training Collaboration between the Tung Wah Group of
Hospitals Integrated Center on Addiction Prevention and Treatment and the
Division on Addiction, Cambridge Health Alliance, a Harvard Medical School
teaching hospital," PI: Howard Shaffer, Ph.D., C.A.S.

The purpose of this project is to guide a multi-year evidence-based clinical
research and training program located at the Integrated Center on Addiction
Prevention and Treatment (ICAPT) in Hong Kong. We intend this program of
activities to lead to enhanced treatment outcomes and provide the
architecture for establishing ongoing clinical studies, including
prospective longitudinal designs and randomized clinical trials. This
architecture will provide the setting for future research activities at
ICAPT as well as both clinical and research training. To this end, we will
establish a training and development program that includes ethics, clinical,
and research activities; this program will feature a “train the trainers”
approach to multiply training experience effects. In addition to web based
clinical and research training, selected Tung Wah staff will participate in
the annual Harvard Medical School Continuing Medical Education live course
in Addiction Medicine, offered by the Division on Addiction, and partake in
the Division’s Continuing Medical Education Distance Learning courses,
administered by Harvard Medical School.

The Cambridge Police Department (CPD) has set up a Safety
Net Collaborative to promote mental health and limit youth involvement in
the juvenile justice system through coordinated services for Cambridge youth
and their families. Safety Net's diversion program targets first-time
juvenile offenders and focuses on connecting them to the necessary services
and programs to prevent recidivism. The Cambridge Department of Human
Service Program assists the CPD in connecting kids in the program to five
youth centers located throughout the city. Cambridge Health Alliance (CHA)
provides phone and in-person consultation, training, evaluation and
treatment services as well as outreach with officers to schools and
families. Diverted youth can seek treatment at CHA, or in other behavioral
health settings. At its five-year juncture, the initiative needs clear
measures of positive outcomes and a more specific plan for data collection
and analysis. The Division on Addiction will work with the CPD's Community
Relations Division to identify measurable predictor and outcome variables to
look at whether involvement in the Safety Net program is linked to positive
outcomes.

Grant from ABMRF: The Foundation for Alcohol Research

"The effect of tailoring a testimonial message on excessive drinking by
personal relevance on implicit and explicit narrative persuasion," Co-PIs: Julia Braverman, Ph.D.,
and John Kleschinsky, M.P.H.

Research suggests that narrative persuasion (i.e., telling vivid stories to
promote attitude change) might be an effective public health promotion
technique. However, it is unclear whether making a narrative story more
personally relevant increases its persuasiveness. This research program
explores this possibility for excessive alcohol consumption. It is well
known that alcohol abuse impairs various domains of life, e.g., health,
social relationships, and career. The importance of these domains varies
from person to person. Hence, some people are typically more concerned about
their social relationships, whereas others pay more attention to their
career, or health. We examine the effect of matching the message content to
what individuals find most personally relevant with two experiments. For the
first experiment, we will ask participants randomly assigned to read
personally relevant, or not, stories about alcohol. We will determine
whether matching personal relevance along three domains (relationships,
career, or health) positively affects individuals’ psychological immersion
into the story, alcohol related attitudes, and self-reported drinking. For
the second experiment, we will use a priming technique to make a specific
domain temporarily more salient (i.e., “activated”) to an individual. This
will allow us to investigate if induced relevance to self can yield
similarly positive alcohol-related health outcomes.

Multi-Year Grant with the Foundation for Advancing
Alcohol Responsibility (FAAR; Formerly The Century Council) to Reduce Repeat DUI by
Developing a
Computerized Assessment and Referral System (CARS)

New research has identified that repeat DUI offenders often suffer from a
number of psychiatric disorders (e.g., Shaffer et al., 2007), suggesting
that untreated mental health issues contribute to the persisting rate of
DUI. To combat this pressing public health problem and to build a foundation
for expanded treatment, the Division of Addiction, with support from FAAR, has begun work to develop and test a computerized clinical
report generator tool, the Computerized Assessment and Referral System
(CARS), for use in DUI intervention and treatment settings. CARS will
package a powerful mental health assessment tool, the Composite
International Diagnostic Interview (CIDI: Kessler & Ustun, 2004) with a
user-friendly interface, increased flexibility, and immediate personalized
output, to create a tool that can be used easily by DUI facility staff to
screen DUI offenders and target interventions to address comorbid mental
health issues. Dr. Ronald Kessler, Professor of Health Care Policy at
Harvard Medical School, co-director of the World Health Organization’s World
Mental Health Surveys, and an original developer of the CIDI, and his team
are collaborating with the Division on the development of CARS.

The Division is sad
to announce that longtime friend and colleague, Dr. Richard LaBrie, died
December 31, 2014. We remember Richard fondly for his quick wit, statistical
prowess, and keen intelligence. Richard was an essential member of the
Division's family, and we will feel his absence for years to come.

The LaBrie family has requested that in lieu of flowers, donations may be
made in Richard's name to the Division on Addiction.
Donations may be made online by listing Richard's name under the Tribute
Information section. Donations may be sent by mail with a check payable to
CHA Foundation with Richard's name in the memo and mailed to the Division on
Addiction, Cambridge Health Alliance, 101 Station Landing, Suite 2100,
Medford, MA 02155.

Cambridge Health Alliance is getting ready for gambling expansion in
Massachusetts. The CHARGE Initiative is an education, information, and
awareness effort that will help people dealing with Gambling Disorder. Visit
our
CHARGE page for more information.

The Division is proud to announce the launch of our
latest online CME course, Disordered Gambling in Your Practice: Information
and Resources for Dealing with Disordered Gambling. The course is
dedicated to increasing providers’ understanding of disordered gambling and
its importance to their practice. To learn more about the course, or to register, please
click here.

Recruitment Opportunities for Studies

Click here
for more information about a smoking cessation study, as well as studies for
veterans.

Waiting time increases risk of attrition in Gambling Disorder
treatment

Attrition is a well known problem in psychotherapeutic
treatment. Patients with addiction have high attrition rates,
and it is therefore important to identify factors that can
improve completion rates in addiction. Here, we investigated the
influence of waiting time as a predictor of treatment completion
in gambling disorder. We compared 48 gambling disorder sufferers
with a 56% completion rate (21 non-completers and 27
completers). Binomial logistic regression analysis showed that
waiting time from initial contact to the first session with a
therapist was a significant predictor of risk of attrition:
longer waiting times were associated with increased risk of
attrition. Age, gender, or comorbidity was not associated with
an increased risk of attrition. These data suggest that gambling
disorder sufferers benefit from fast access to treatment, and
that longer waiting time increases the risk of attrition.
Click
here to visit the Library & Archives page.

Changing social networks among homeless individuals: A
prospective evaluation of a job- and life-skills training
program

Social networks play important roles in mental and physical
health among the general population. Building healthier social
networks might contribute to the development of self-sufficiency
among people struggling to overcome homelessness and substance
use disorders. In this study of homeless adults completing a
job- and life-skills program (i.e., the Moving Ahead Program at
St. Francis House, Boston), we prospectively examined changes in
social network quality, size, and composition. Among the sample
of participants (n = 150), we observed positive changes in
social network quality over time. However, social network size
and composition did not change among the full sample. The subset
of participants who reported abstaining from alcohol during the
months before starting the program reported healthy changes in
their social networks; specifically, while completing the
program, they re-structured their social networks such that
fewer members of their network used alcohol to intoxication. We
discuss practical implications of these findings. Click
here to visit the Library & Archives page.